More Proportional Feminine Look Through Breast Implants?

Question

I am a large framed person at 5'6" and 190 pounds. I am healthy and well-proportioned, except I have broad shoulders and my legs and arms are muscular ( I believe so because I used to lift weights and run). I am upset because I feel masculine with my shoulders. I also have breast tissue under my arms (see photo) which becomes sore when I have PMS.I would like a breast augmentation, if possible. I am trying to figure out if larger breasts would better balance my proportions or make me look even more bigger all over. I would like to avoid looking like an "Amazon" woman. Any suggestions on sizing or placement of implants? Note: I am 40 years old.

Farbod Esmailian, MD · Answer

At this point I would have to agree with the other doctors. The ideal thing would be to lose as much weight as you can to come close in range to your ideal height-weight. At that point then adding breast implants would be the way to go as you breasts would likely deflate with the weight loss.

Austin Hayes, MD · Answer

Thank you for your question sorry to hear about your concerns. The most important factor when sizing implants, is working closely with your surgeon, in person, to find the implant size that gives you the look that you desire. Careful measurements of your breast and chest wall will help determine which size implants will fit within your natural breast footprint. Taking into account your desired look, and your measurements, an implant is chosen that specifically fits your body.  Unfortunately, online recommendations are not that helpful. Make sure that you have a good relationship with your plastic surgeon, so that you two can work together to find the right size. In my office, patients try on implants in a bra and clothing. There able to see how they look in the mirror, and in photographs. Most women know they have found the right size when their breasts come into balance with their shoulders, waist, hips and buttocks. Women are also encouraged to bring in wish pictures, so that I can get a sense of the look that they would like to achieve. Breast tissue that is in your armpits can also be during the procedure.

Otto Joseph Placik, MD · Answer

The answer to this question deserves more than a paragraph. To properly answer your question, I would suggest sizers to visualize the impact of larger breasts on your frame and overall appearance.

Joseph G. Bauer, MD, FACS · Answer

Many women have breast augmentation surgery in their 40’s so I wouldn’t let that discourage you. Many of the women that come to my practice are mothers who are looking to achieve the look they had pre-pregnancy. I would suggest scheduling consultations with local board certified plastic surgeons and discussing your options. Bring pictures of the look you are hoping to achieve and express your desires with your surgeon.

Pablo Prichard, MD · Answer

Dear Nomore,I think what you are asking is will you look heavier or overall larger with large implants.I think this depends on what you are wearing. If you have very large implants and wear something that is not fitted at the waist, then the larger breast will make you look larger in general. However, if you are wearing a bikini or a fitted shirt that shows off your waist line, then no, it will actually look like your waistline is smaller since your chest/hip ratio is larger.Best Wishes,Pablo Prichard, MD

Tom J. Pousti, MD · Answer

Thank you for the question.

	The more breast surgery I do the more I realize that there is no correlation between the size or model (profile) of implant used and resulting cup size.  This may have to do with several factors including: the amount of breast volume the patient starts with, the shape of the patient's chest wall (concave or convex), the type and model of breast implant selected (saline/silicone  and low/moderate/high profile), bra  manufacturer variance  in cup sizes, the  degree  of filling of the cup  with breast tissue,  and the subjective differences in patients perceptions of cup size.  Much of the final &ldquo;look&rdquo; achieved after breast augmentation surgery  depends on several factors:  1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation &ldquo;look&rdquo; will be optimal.   2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.  3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result. On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants. Other differences involve how the breast implants are filled. Saline implants are filled after they&rsquo;re implanted, so saline implants require a smaller incision than prefilled silicone breast implants. On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers&rsquo; saline-filled breast implants are considered investigational. As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.   4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of &ldquo;goal&rdquo; pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as &ldquo;natural&rdquo; or &ldquo;C cup&rdquo; or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate. I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison. I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible. By the way, the most common regret after this operation, is &ldquo;I wish I was bigger&rdquo;.

	  I hope this helps.

Fredrick A. Valauri, MD · Answer

The first thing to do is to have a consultation with a board certified plastic surgeon.  You will be examined and a full discussion of your breast implant options and preferences will be explored.

	I  suggest that you bring several photos of what you thing you want as your goal. These photos may be helpful in deciding upon the choice of implant size, shape and pocket position when combined with the information provided by your breast implant consultation.

Steven Wallach, MD · Answer

To size you properly for breast implants, requires a physical exam and a discusion of your goals. You should be able to get implants that are size appropriate.

Bahram Ghaderi, MD · Answer

Being proportionate is a key goal in breast implant surgery. If you need to lose weight first to appear more proportionate, then that is the first step to take before having breast implants. If you appear larger that you would like, adding volume to your breasts with implants will exaggerate what you already don't like - may make you appear more top heavy. Once you are close to your goal weight and stable at your weight, then it is a good time to research breast augmentation and you will also be in a good place to choose the right size to give you the feminine look you are after. Remember that weight loss can cause breasts to sag and you make need a breast lift. So, better to have your weight loss now rather than after surgery. Obviously the best way to have your question answered is to have a full consultation and comprehensive exam by a board certified plastic surgeon.

John P. Stratis, MD · Answer

Here would be the ideal way of improving your physical femininity.
1. Weight loss- for your height you frankly weigh too much. You would do well to get onto a weight loss program with mild weight training and aerobic activity.
2. Directed liposuctioning to help form certain areas better. (I spy a little neck fat that would be a great place to start)
3. Breast implants or lift. You need to be careful with adding additional volume to your chest because it can make you look less feminine
If you find you cannot lose the weight you may want to focus on liposuctioning to help create a more feminine form.

More Proportional Feminine Look Through Breast Implants?

Answers (11)

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